CPAP

Since the earthquake on January the 12th, we have seen an increase in premature births in our area. Expectant mothers are under a great deal of stress, and this seems to be sending many of them into preterm labour. The result; many babies are being born with low birth-weights and immature organ systems.

At God's Littlest angels, two premature infants have died recently. We believe that they might have lived, if we had been able to provide CPAP to help them breath. With the help of Heather Maeding, a Neonatal Nurse Practitioner from Pennsylvania, GLA has managed to obtain a Bubble CPAP set-up for the smallest babies at the orphanage. There is just one problem - no-one here knows how to use it.

CPAP stands for Continuous Positive Airway Pressure. CPAP is a therapy that provides breathing support for babies who are born prematurely, with underdeveloped lungs. It can also be used to treat infants and toddlers with pneumonia, who would otherwise need to be ventilated in order to survive. The continuous pressure, which is provided through prongs that sit just inside the nostrils, helps keep the baby's airways open. It splints their chest so that breathing is less work. It prevents the lungs from collapsing and facilitates better gas exchange.

Watch this video to see bubble CPAP in action in North America:





Bubble CPAP is a safe, simple and cost-effective way of providing respiratory support to infants in the developing world. It is less invasive that a ventilator and CPAP does not damage infants' fragile lungs in the way that mechanical ventilators can.

CPAP has been shown to dramatically improve the survival of premature babies, born in resource-poor countries. In one centre, 1 in 10 babies died before the introduction of bubble CPAP. Afterwards, 9 out of every 10 babies lived!

As I understand it, even extremely low birth weight babies, weighing less than 2lb can benefit from CPAP, so long as they are making an effort to breath by themselves. Many of the infants who have died at GLA were born at  a weight and at a stage in their development that might have made them good candidates for bubble CPAP

Tomorrow, I am flying out to Pennsylvania, where I will receive some training from Heather Maeding and her colleagues at Saint Luke's Hospital. This training should ensure that I can set up bubble CPAP and care for and monitor the infants we place on this breathing system. I will then pass on this knowledge to our Haitian nurses.

It is very exciting to be able to provide CPAP at God's Littlest Angels. We will be one of the only centers in Haiti to offer this therapy. Few of the existing neonatal or paediatric intensive care facilities in this country are able to ventilate sick babies and children. There are just a handful of Neonatal Intensive Care Units in the sprawling city of Port-au-Prince and most do not even admit babies who are born at home.  Since most Haitian mothers can not afford the costs of a hospital delivery, our drive to implement CPAP really will help minister to 'the least of the least,' babies who are excluded from both government and private health care facilities.